How much rates vary
Facilitymedian $138 · 10th to 90th $83 to $162Professionalmedian $123 · 10th to 90th $76 to $219
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $87.10 Median $93.33 Typical High $128.82 | Facility | None | $87.10 | $93.33 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $128.82 | Professional | None | $67.61 | $89.13 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $245.47 | Professional | None | $102.33 | $141.25 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $204.17 | Professional | None | $128.82 | $173.78 | $204.17 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $173.78 Typical High $186.21 | Facility | None | $95.50 | $173.78 | $186.21 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $208.93 | Professional | None | $74.13 | $107.15 | $208.93 |
Pacific Source Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $158.49 | Facility | None | $83.18 | $138.04 | $158.49 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $147.91 Typical High $186.21 | Facility | None | $87.10 | $147.91 | $186.21 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $234.42 | Professional | None | $79.43 | $134.90 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $223.87 | Professional | None | $134.90 | $141.25 | $223.87 |
United Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $281.84 | Professional | None | $100.00 | $134.90 | $281.84 |
9 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $33.88 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $10.23 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.76 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $112.20 Median $186.21 Typical High $269.15 | Professional | 24 · Unrelated visit after surgery | $112.20 | $186.21 | $269.15 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $91.20 Median $199.53 Typical High $269.15 | Professional | 25 · Same-day visit | $91.20 | $199.53 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $33.88 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $10.23 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.92 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier GC · Resident with teaching physician Typical Low $77.62 Median $131.83 Typical High $245.47 | Professional | GC · Resident with teaching physician | $77.62 | $131.83 | $245.47 |
Where Oregon sits
The same service costs 2.3 times more in Alaska than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oregon· 8th of 51
$129
AK $155NJ $67.61
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.